Hearing Rights

PURPOSE: This rule establishes procedures by which an applicant or consumer dissatisfied with a determination made regarding the provision of services by the Department of Health and Senior Services (DHSS) can request a hearing. (1) When an applicant or consumer is determined ineligible for consumer-directed services (CDS) or when a dispute arises concerning the provision of CDS, after preparation of the CDS plan (plan of care), or termination of CDS, the applicant or consumer may request, in writing, a hearing with the Department of Social Services (DSS). (2) An applicant or consumer may request a hearing by contacting Department of Health and Senior Services (DHSS) in writing within ninety (90) days of denial of eligibility, denial of financial assistance, the determination of financial assistance, discontinuation, suspension or reduction of CDS. (3) If the consumer appeals in writing within ten (10) days of the mailing of the notice regarding denial, suspension, reduction or termination of CDS, DHSS will not suspend, reduce, or terminate services provided to a consumer under an existing plan of care pending a decision from a hearing, unless the consumer requests in writing that services be suspended, reduced or terminated. (A) The consumer shall be responsible for repayment of any federal or state funds expended for services while the appeal is pending, when if DHSS’ decision is upheld and the state requests repayment of such funds. AUTHORITY: sections 208.921, 208.927 and 208.930, RSMo Supp. 2005.* This rule originally filed as 5 CSR 90-7.300. Original rule filed June 28, 2001, effective Jan. 30, 2002. Moved to 19 CSR 158.500, effective Aug. 29, 2005. Emergency amendment filed Dec. 15, 2005, effective Dec. 25, 2005, Expired June 23, 2006. Amended: Filed Dec. 15, 2005, effective July 30, 2006. *Original authority: 208.921, RSMo 2005; 208.927, RSMo 2005; and 208.930, RSMo 2005.